Early Risk Factors and Emotional Difficulties in Children at Risk of Developmental Language Disorder: A Population Cohort Study

Abstract

Purpose This study evaluated the pathways between developmental language disorder (DLD), psychosocial risk factors, and the development of emotional difficulties from ages 3 to 11 years within the Millennium Cohort Study. Method A total of 14,494 singletons (49.4% female) from the Millennium Cohort Study were evaluated within this study. Risk of DLD (rDLD) was defined as age 5 parent-reported language problems and/or −1.5 SD s on a Naming Vocabulary subtest at the age of 5 years. Children without rDLD formed the general population comparison group. Psychosocial risk factors included 9-month temperamental traits, parental psychological distress, and maternal attachment as well as age 3 emotional regulation abilities, parent–child relationship, and peer problems. The parent report Strengths and Difficulties Questionnaire Emotional Difficulty subscale at 3, 5, 7, and 11 years of age was the outcome variable. The trajectory of emotional difficulties was evaluated within a variable-centered approach and a person-centered approach, using growth mixture modeling. Results Children with rDLD ( n = 884) had increased levels of emotional problems when compared to the general population group ( n = 13,344). Psychosocial risk factors were increased in children with rDLD, fully mediated the increased emotional difficulties at 3 years, and partially mediated the increased emotional difficulties at 11 years. Children with rDLD were more likely to be included in emotional trajectory subgroups with an increasing pattern of emotional problems. rDLD was an additional risk factor for lower levels of emotional self-regulation and increased peer problems when controlling for the emotional difficulties trajectory subgroup. Conclusion This article indicates that the increased emotional difficulties found in children with rDLD are likely a function of early language difficulties influencing other domains of development, specifically social interactions (parent and peer) and emotional self-regulation abilities. Clinically, this reiterates the importance of early identification and treatment of children with language delays or clinical level language disorders. Supplemental Material https://doi.org/10.23641/asha.8323598

Behavioral, Emotional and School Adjustment in Adolescents with and without Developmental Language Disorder (DLD) Is Related to Family Involvement

“…With respect to the externalized problems, Font-Jordà et al [4] did not report more externalized behaviors in a clinical sample of Spanish-Catalan children with DLD. In contrast, previous studies have shown that externalized behaviors increase from kindergarten to grade four in children with a low language level [11,12,23]. Nevertheless, this relation is greater for males and is mediated by other variables such as peer rejection [68].…”

“…For example, young adults with language difficulties have thrice more possibilities of presenting social anxiety (previously called social phobia) than typical peers [22]. Furthermore, experiencing problems in emotional regulation and difficulties in communicating about one's emotions and the emotions of others are some of the factors that seem to underlie emotional difficulties [18,23,24]. In this sense, a curious phenomenon occurs in persons with DLD: while they inform similar levels of social skills than their peers in self-reports, they suffer more stress than the others in social situations [25].…”

Trajectories of prosociality from early to middle childhood in children at risk of Developmental Language Disorder

“…There were 65 children who met both criteria of parent report of language difficulties and low score on the naming vocabulary subtest at age 5. Although there are two distinctive routes to being categorised as r-DLD, previous research with this classification has shown striking similarities in results when analysed separately by each r-DLD criteria (Forrest et al, 2018;St Clair et al, 2019), giving reassurance that the combined variable is a valid measure of risk for DLD. The prevalence estimate of the risk of DLD in our sample was 6 %, which is in line with previous estimates of 5-7% (Norbury et al, 2016;Tomblin et al, 1997).…”

“…Recent research supports this assertion. Children at risk of DLD have lower scores on a parent-child relationship measurement, which is perhaps indicative of fewer opportunities to learn from parental social exchanges (St Clair et al, 2019). Furthermore, given that heritability of DLD is high (Bishop & Hayiou-Thomas, 2008), children with DLD may grow up in families where parents also have language difficulties, which may further limit the frequency or quality of meaningful social exchanges.…”

“…We implemented criteria to identify children at risk of DLD which have previously been used in the same cohort (Forrest et al, 2018;St Clair et al, 2019). Children had to meet at least one of the following two language criteria to be included in the r-DLD group.…”